In facial alopecia areata rubbing of the affected region daily with tincture of cantharides, either pure or mixed with spirit of rosemary, according to the irri tability of the skin, is another valuable measure.
Tincture of cantharides, 1 ounce. Spirit of rosemary, 2 drachms to 1 01111 cc.
The hair should be cut short. Van Swieten's solution rubbed in. and each diseased patch painted with a thick coat ing of 1 part of iodine to 30 of collodion. At the end of a week this film loosens and begins to separate. Frictions with the sublimate solution are then used, morning and evening, until all the re maining pellicles of collodion have been removed, when a new coating of iodized collodion is applied. After three applica tions the downy, new hairs begin to appear. Tison (Jour. de MM., Apr. 24, '92).
Antiseptic preparations have been recommended by a large number of authorities.
In parasitic alopecia areata (tricho phytosis) the hair is cut close, and a solution of corrosive sublimate (1 to 750) or, preferably,—on account of its non-toxic qualities,—a 3-per-cent. solu tion of creolin is applied. This is used all over the scalp as a preventive. Sapo viridis is rubbed into the affected areas, and allowed to remain on for five min utes. After washing this oft, a small quantity of the following ointment is rubbed in:— IF Hydrarg. bichlor., 1 grain. Lanolin, 1 ounce.
To be thoroughly mixed.
The latter should be applied twice daily, as a usual thing, but sometimes a less frequent application suffices.
In neurotic alopecia areata the same internal treatment is used as in presenile alopecia. Externally, in some eases, cantharidal collodion is applied to the affected area, and, after vesication has been established, a dressing of some bland ointment. As the collodion varies in its effect, it is to be applied at greater or less intervals.
Bulkley's method, with some modifi cations, is as follows: The pure carbolic acid is applied twice a week, and over the entire area of the patch, however large, by freely swabbing. Those por tions which are affected by the acid turn milky white in a few moments, and, if they do not do this, are touched again after awhile. If the parts that turn
white show any very marked inflamma tory action, they are passed over at the next sitting. Generally, however, there is, at most. but a slight amount of des quama tion. (Oh mann-Dumesnil.) Case of alopecia areata of the beard treated by Martin's method of locally applied mereuric-bichloride solution, made to penetrate the follicles by elec tricity. Beall (Va. Med. Monthly, Feb., '91).
Affected area covered with solution of corrosive sublimate in glycerin, 1 to 100. The scalp is then tattooed with a sharp instrument: an aseptic needle, for in stance. The punctures need only be slight—sutlicient to permit penetration of the antiseptic. Successful results in most inveterate cases. M. A. Martin (Gaz. des July 9, '95).
Successful treatment of alopecia areata by means of lactic acid, applied gradu ally in increasing strengths, beginning with a 50-per-cent. solution. Ristema (Brit. Jour. of Derm., July, '98).
A 50-per-cent. aqueous solution of lac tic acid has a remarkable effect in alo pecia areata. As the remedy is quite irritating, it should not be used more than once a day. If the pain should be very severe the acid is to be suspended temporarily and anodyne applications used. In the large majority of cases cure was complete in three months. Stojanovitch (Ann. de Dermat. et de Syph.. Sept.. '99).
The local use of strong solutions of carbolic acid has been advocated by Duhring and Bulkley.
Three cases cured in five weeks by painting the patches with iodized collo dion, l to 30. It is supposed that the impervious coating formed by the collo dion kills the micro-organism. Chatelain (Revue Gen. de Clin. et de TWr., Dec. 31, '90).
The scalp is thoroughly washed for ten minutes with tar-soap, first using hot water. then cold. The parts having been thoroughly dried, a solution of hichloride of mercury. 1 to 900 (equal parts of water, g,lycerin, and cologne), is rubbed in. The scalp is then anointed with a pomade containing 13 Salicylic acid, 2 parts.